The long-term objective of the proposed conference is to set a precedent for a national educational forum that will coalesce and disseminate clinical quality improvement knowledge in the ambulatory care arena. The significance of this conference is its emphasis on clinical performance measurement and quality improvement at the ambulatory care level, where the majority of care is delivered in the United States - not in the inpatient setting. Our specific aims in convening the proposed conference include discussing clinical performance measurement study design and methodology, disseminate the results of AAAHC Institute for Quality Improvement (IQI) studies, and consider new research topics for IQI. In addition to IQI activities, it is also anticipated that conference participants will have the opportunity to learn of other widely available clinical quality improvement resources (such as those offered by the agencies within the Public Health Service) and discuss ambulatory setting quality of care issues/concerns with national clinical quality improvement experts. In order to achieve these goals, a three-day conference, over a weekend, in a location easily accessible from both US coasts, is planned. The agenda will include two general sessions. For one general session, nationally recognized experts will discuss their methods for developing and conducting clinical quality improvement activities in their settings (Intermountain Health Care and the Dartmouth Hitchcock Clinic). In the other general session, representatives of various types of ambulatory care organizations, including managed care, a network of ambulatory surgery centers, a community health care clinic, and an office-based surgery practice, will discuss their clinical quality improvement activities, issues that have arisen in conducting these activities, and their plans for future activities. Between these, participants will be offered two tracks of small group discussions/workshops: one on primary care and another on surgical/procedural care, as well as some "crossover sessions" (priority planning; medical event reporting; risk management...). Topics for workshops will include: ambulatory health care performance measurement priority setting; alternative ambulatory quality improvement programs; asthma management in the college health setting; cataract surgery; diabetes management; diagnostic colonoscopy; knee arthroscopy; medical event reporting; patient satisfaction with an injectable COX2 inhibitor; primary care patient satisfaction; risk management; and surgical/procedural patient satisfaction. Invitees will include: ambulatory health care physicians, allied health personnel, and administrators, as well as representatives the Public Health Service, health services researchers, patient organizations (disease-, age-... specific), and private organizations that fund health services research.